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Int Heart J. 2021;62(5):988-996.

Time Course and Risk Factors of New-Onset Complete Atrioventricular Block After Transcatheter Aortic Valve Implantation.

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제1저자 차명진 · 교신저자 김효수

PMID 34544968 DOI 10.1536/ihj.20-824 IF 1.4 순환기내과
소속 (1)
  1. Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital.

Abstract

In this study, we aimed to investigate the time course of new-onset complete atrioventricular block (CAVB) and its reversibility after transcatheter aortic valve implantation (TAVI). We analyzed 206 consecutive patients without baseline CAVB who underwent successful TAVI. The incidence of new-onset CAVB was determined to be 12.6% (26/206). Among these patients, 14 recovered from CAVB within 2 weeks (6.8%, 14/206), while the remaining 12 (5.8%, 12/206) underwent permanent pacemaker (PPM) insertion. Among the 12 patients who received the PPM, 4 were able to recover from CAVB within 4 months. Thus, only 8 among 206 patients (3.8%) showed persistent CAVB. Early-onset CAVB on the day of the procedure was the strongest predictor of PPM implantation (OR = 127). The electrocardiographic changes that occurred after TAVI were mostly recovered after 1 month. The most critical procedural factor that predicts CAVB and PPM insertion is the deep implantation (>4 mm) of a big valve (oversizing index >5.9%). In conclusion, the incidence of CAVB after TAVI was estimated to be at 12.6%. Two-thirds of these patients recovered from CAVB within 3 days, resulting in a final rate of persistent CAVB of 4%. To prevent CAVB, we have to implant an appropriate valve type with an optimal size and depth.

Keywords

ArrhythmiasCardiacPacemakerTranscatheter aortic valve replacement

그 밖의 정보
출판 형태
Journal Article, Observational Study
저널
International heart journal · eISSN 1349-3299
전자 출판
2021-09-17
MeSH
Age of Onset · Aged · Aged, 80 and over · Aortic Valve Stenosis / diagnosis / surgery · Atrioventricular Block / epidemiology / etiology / physiopathology / therapy · Electrocardiography / methods · Female · Heart Valve Prosthesis Implantation / adverse effects / methods · Humans · Incidence · Long QT Syndrome · Male · Pacemaker, Artificial / adverse effects · Predictive Value of Tests · Recovery of Function / physiology · Republic of Korea / epidemiology · Retrospective Studies · Risk Factors · Time Factors · Transcatheter Aortic Valve Replacement / adverse effects / instrumentation